MR. KELLY JOE THOMAS BS MT(ASCP) CLS(NCA) NPI 1255663670

NPI Information

NPI: 1255663670
Provider Name: MR. KELLY JOE THOMAS, BS MT(ASCP) CLS(NCA)
Classification: Specialist/Technologist, Pathology - 246QM0706X
Entity Type: Individual

Specialization: Medical Technologist

Address:
3200 CANYON LAKE DR
RAPID CITY, SD
ZIP 57702
Phone: (605) 355-2229
Get Directions

MR. Kelly Joe Thomas, BS MT(ASCP) CLS(NCA) is a medical technologist specialist technologist pathology in Rapid City, SD. MR. Kelly Joe Thomas, BS MT(ASCP) CLS(NCA) NPI is 1255663670. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3200 CANYON LAKE DR
RAPID CITY, SD
ZIP 57702-114
Phone: (605) 355-2229
Fax: (305) 355-2514

The enumeration date for this NPI number is 2/10/2010 and was last updated on 2/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246QM0706X	Specialist/Technologist, Pathology	Medical Technologist	206256		No
2	246QM0706X	Specialist/Technologist, Pathology	Medical Technologist	204742		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0140070	MEDICAID	SOUTH DAKOTA
2	5549050	OTHER	SOUTH DAKOTA	MEDICAID
3	PHS000	MEDICARE UPIN	SOUTH DAKOTA
4	430082	MEDICARE OSCAR/CERTIFICATION	SOUTH DAKOTA
5	HSZ050	MEDICARE PIN	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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